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L2425 — Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint

HCPCS Level II L-code · short descriptor: “Knee disc/dial lock/adj flex”

Code system
HCPCS Level II
Family
L — Orthotics & prosthetics
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Prosthetics & orthotics
Prior authorization
Not on Medicare required-PA list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

L2425 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $171.93 to $189.18 depending on state and rural status.

Former-CBA payment limits: ceiling $209.83 · floor $157.37

StateNon-ruralRural
AK$171.93
AL$177.12
AR$177.11
AZ$171.93
CA$171.93
CO$178.12
CT$171.93
DC$171.93
DE$171.93
FL$177.12
GA$177.12
HI$171.93
IA$175.28
ID$171.93
IL$176.17
IN$176.17
KS$175.28
KY$177.12
LA$177.11
MA$171.93
MD$171.93
ME$171.93
MI$176.17
MN$176.17
MO$175.28
MS$177.12
MT$178.12
NC$177.12
ND$178.12
NE$175.28
NH$171.93
NJ$171.93
NM$177.11
NV$171.93
NY$171.93
OH$176.17
OK$177.11
OR$171.93
PA$171.93
PR$189.18
RI$171.93
SC$177.12
SD$178.12
TN$177.12
TX$177.11
UT$178.12
VA$171.93
VI$189.18
VT$171.93
WA$171.93
WI$176.17
WV$171.93
WY$178.12
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Common denial codes to watch

Related L-codes

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